ACCELERATED (MALIGNANT) HYPERTENSION - A STUDY OF 121 CASES BETWEEN 1974 AND 1996

A series of 121 consecutive cases with accelerated hypertension is pre sented. Forty-seven patients had essential hypertension, This diagnosi s was confirmed during the follow-up, which lasted from 3 to 255 month s (mean 63.1 +/- 58.1). The relationship between the effects of pharma cological treatment on high blood pressure (BP) and disease course wer e analyzed in accelerated essential hypertensive patients only, to avo id the imponderable influence of basic disease in secondary hypertensi on, In most cases, therapeutical effect on EP was monitored by multipl e daily BP self-measurements. Since 1974, when this study was initiate d, plasma creatinine concentration at admission showed a clear-cut dec rease, especially after the introduction in the eighties of new hypote nsive drugs, A sustained BP decrease assured a long-lasting preservati on of renal function, if the initial functional loss was limited (plas ma creatinine concentration of 2 mg/dl (176.8 mu mol/l) or less), Rena l function was preserved even if the BP decrease was not optimal and s igns of relapsing malignant retinopathy were observed in the course of disease, Although the whole series showed a 12-year survival rate of about 69%, patients enrolled after 1980 had a 100% survival rate.